title: Behavioral changes associated with economic development in the South Pacific: health transition in Vanuatu.
abstract: Health patterns are changing in developing countries; as diet and activity patterns change with economic development, chronic disease prevalence increases, which is a characteristic of health transition. The islands of Vanuatu (South Pacific) have varying rates of economic development and provide a natural experimental model of health transition.
  
  
  OBJECTIVE
  To characterize behavioral changes associated with modernization.
  
  
  METHODS
  We surveyed 425 children and 559 adults on three islands varying in degree of economic development. We assessed diet (24-h dietary recall), physical activity (mode of transport, work activities, and recreation), substance use, and other behavioral patterns.
  
  
  RESULTS
  Spending patterns and access to Western foods followed modernization gradients in our sample, whereas occupational patterns and ownership of technological goods were poor markers of modernization. With increasing economic development, participants consumed more animal proteins and simple carbohydrates. Physical activity levels were high; most participants were active in gardening, and sports were popular, especially in urban areas. However, urban participants spent more time in sedentary recreation. Men's use of alcohol and tobacco increased with economic development, but we observed marked differences in substance use patterns between two rural islands-one with and one without tourism.
  
  
  CONCLUSIONS
  Economic development in Vanuatu is accompanied by nutrition transition and increased sedentary recreation, although physical activity levels remain high. Differences in substance use patterns between rural islands with and without tourism indicate a need for more research in rural areas. These findings might inform research in other communities in the early stages of health transition.
authors.affiliation: Department of Psychiatry, McGill University, Montreal, Quebec, Canada H4H1R3. kelseydancause@gmail.com
authors.forename: Kelsey Needham
authors.initials: KN
authors.lastname: Dancause
authors.forename: Christa
authors.initials: C
authors.lastname: Dehuff
authors.forename: Laura E
authors.initials: LE
authors.lastname: Soloway
authors.forename: Miguel
authors.initials: M
authors.lastname: Vilar
authors.forename: Chim
authors.initials: C
authors.lastname: Chan
authors.forename: Michelle
authors.initials: M
authors.lastname: Wilson
authors.forename: Len
authors.initials: L
authors.lastname: Tarivonda
authors.forename: Ralph
authors.initials: R
authors.lastname: Regenvanu
authors.forename: Akira
authors.initials: A
authors.lastname: Kaneko
authors.forename: Ralph M
authors.initials: RM
authors.lastname: Garruto
authors.forename: J Koji
authors.initials: JK
authors.lastname: Lum
mesh_terms: D000293:Adolescent; D000328:Adult; D003906:Developing Countries; D004032:Diet / Q000639:trends; D057217:Economic Development; D005260:Female; D005518:Food Preferences; D006306:Health Surveys; D019456:Health Transition; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D012307:Risk Factors; D012922:Social Change; D012959:Socioeconomic Factors; D009514:Vanuatu